ABSTRACT
This chapter explains the principles, concentrating predominantly on vitreous surgery for retinopathy of prematurity (ROP). The two primary goals of pediatric vitreoretinal surgery are to attach the posterior pole and to avoid creating a retinal break. Any child referred for vitreoretinal surgery needs a comprehensive history and physical examination by a pediatrician, anesthesiologist, and ophthalmologist. Pediatric patients undergoing general anesthesia should be attended by experienced pediatric anesthesiologists. Once the child has been placed under general anesthesia, the head is stabilized with a pediatric donut. An unfolded towel may be placed between the donut and the child’s head. In the unfortunate event that a retinal break is discovered or created during vitrectomy, a scleral buckle procedure is advised in addition to the vitrectomy. While the scleral buckle procedure has exhibited modest success as a stand-alone procedure for tractional retinal detachment in ROP, the development of a rhegmatogenous component augurs a poor outcome.
